Care of the Insane?A Contrast in Methods
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In the care of the insane we have certainly advanced far beyond the methods of the eighteenth century, when persons of disordered mind were locked up in prisons and chained to posts in underground cells for safe keeping. How much further we Americans have to progress before we come within reach of anything worth calling an ideal, we may learn from a paper by Dr Frederick Peterson in The Survey for last week. Dr Peterson is professor of psychiatry at Columbia University and ex-president of the New York State Commission in Lunacy. For many years he has been engaged in the struggle to improve New York asylums for the insane. What the conditions must be in these colossal and overcrowded institutions can be guessed at when Dr Peterson says, “I have known of mattresses laid upon floors in hallways, bathrooms and even in toilet rooms to accommodate the overflowing wards. Exercise out of doors is apt to be taken at fixed hours in a march around the grounds, double file in columns of fifty to two hundred with attendants as guards at each end and along the sides. A few trusty patients are worked on the farm and about the grounds, and some make scrubbing brushes and pick hair for handicraft work. Some make beds and drag a heavy floor-polisher through the wards and corridors. But the great majority sit idle and listless in long lines throughout the wards the entire day.” From this discouraging prospect it is a relief to turn to the description of two remarkable colonies or villages for the insane which Dr. Peterson has visited. One is in France, at Yanves near Paris, founded a hundred years ago by Doctors Voisin and Falret. A park of sixty acres is divided into two parts,?one for women, the other for men, ?by a farm in the middle. Many little cottages have been built, each with its own garden enclosed by tall hedges. Here the patient can be isolated not only from his old associations, but also from contact with other insane people.
The other colony is the charming village of Iwakura near Kyoto, Japan. About nine hundred years ago the temple and holy well of Iwakura became famous through the cure there of the Emperor’s daughter who had suffered from melancholia. In 1889 the village consisted of 239 families, each receiving one or two insane patients “to share in the occupations of the household, which are chiefly out-of-door employment in fields, gardens and parks and some of the arts and crafts of the ordinary Japanese home.” Dr Peterson remarks upon the charm of the place, the simplicity of its architecture, the beauty of its gardens and woods, the airiness of the little hoiises, the exquisite cleanliness of everything, and best of all the delightful manners of the inhabitants. “No doubt we of the West,” he concludes, “will some day be glad to copy this Japanese model when we finally awaken to how far we have drifted from an ideal system of care and treatment of the insane, with our immense, expensive and complicated machinery of mere support and custody.” But with an unmistakable accent of regret he adds, “I believe such gentleness, kindness, patience and assiduous attention to the sick could be found nowhere else, for nowhere else exists a whole race of people who never scold, quarrel, or manifest impatience, but always turn a smiling face and extend a helping hand to one another.”
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